Arch Hand Microsurg.  2023 Mar;28(1):52-56. 10.12790/ahm.22.0059.

A rare case of nerve compression caused by a connected lipoma of the wrist

• Kim D
• Yoon J
• Eo S
• Han Y
• Lim S

• KMID: 2540032
• DOI: http://doi.org/10.12790/ahm.22.0059

Abstract

A variety of benign and malignant neoplasms can develop in the hand, originating from skin, adipose tissue, tendons, muscles, nerves, and bones. However, most cases are benign; therefore, observation is recommended if they are small, painless and do not cause limitation of motion. When symptoms are present or a lesion is larger than 5 cm in the long axis, an excisional biopsy is required to relieve symptoms and exclude malignancy. Lipomas of the hand are quite rare and do not generally cause symptoms. Lipomas of the hand that do present with symptoms are usually giant (larger than 5 cm in diameter) or located in a deeper layer, compressing the nearby nerves and vessels. We report a rare case of a non-giant superficial lipoma of the wrist that resembled two separate masses and caused pain, limitation of motion, and neurological symptoms.

Keyword

Giant lipoma; Hand; Wrist

Figure

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  Fig. 1. Preoperative photograph. Two apparently different palpable masses were located on the right wrist; one on the radial dorsal aspect, and the other on the wrist crease.

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  Fig. 2. Preoperative ultrasound images of (A) the radial dorsal aspect mass and (B) the wrist crease mass. The estimated lengths were 1.84 cm (A) and 1.23 cm (B) in the long axis.

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  Fig. 3. Preoperative photograph. An elliptical incision line was drawn on the radial dorsal aspect of the wrist.

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  Fig. 4. Intraoperative photograph. The mass on the radial dorsal aspect was approached first.

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  Fig. 5. Intraoperative photograph. A well-circumscribed mass (2.5×4.5 cm2) was completely removed (3.0×2.0 cm2 on the radial dorsal aspect, and 1.5×1.2 cm2 on the wrist crease.)

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  Fig. 6. Postoperative photograph. A drain was inserted to prevent hematoma formation.

Reference

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